Pulsing azithromycin and rifampin

If you've been taking rifampin and azithromycin for 4 years and you still have bartonella symptoms, it's not working.

I found azithromycin ineffective on bartonella unless I also took atovaquone to knock out its efflux pumps, otherwise the bartonella will just spit out the azithromycin and you will get nowhere with it.

Tinidazole can be effective on bart, but this drug tends to have a high risk of side effects.

If you have methylation issues, this is usually from too much adrenaline production (ie methylation of norepinephrine). Did this show up on a blood test as affecting folate, B12, or carnitine? If so, you'll want to be careful taking rifampin, as it induces CYP3A4 which can metabolize cortisol and further stress your adrenals.

I didn't find pulsing to be all that effective on bartonella as it grows back pretty quickly. The only bart treatment I pulsed was minocycline, and the reason I did that was because mino suppresses the immune response, so I needed to take a day or two off to let my immune system recover.

summer16 said...
Hi all! I haven taking rifampin and azithromycin daily for at least 4 years and still have some major symptoms left which are shortness of breath, anxiety at times, brain fog and fatigue to name a few. I just tested negative for Babesia using the new Babesia Panel 2 through Igenix. I am on the lower doses of these meds because I have big time methylation issues and have quite strong Herxing issues. Anyway, I would like to try pulsing these meds which my llmd does not agree. From what I have read about pulsing I would pulse these meds M-W-F for 2 weeks and then off one week. I would like to add Tinidazole on Tues and Thurs if my doc would prescribe it but if not what can I take instead of that? I do take OoO daily but wondering if that should be pulsed also. I really need some help.
Patty

I wouldn’t rely on a negative Babesia test.
Why not take some Mepron (plus an antibiotic) for a few months?

Also maybe substitute Rifabutin instead of Rifampin.

summer16 said...
I am surprised no one is answering my pulsing question.
Just called and left a message with Dr.J. I really do need further help and hopefully get on the right track.
Thank you Quin and Girlie.

What is the reason your dr doesn’t want you to pulse the abx ?

summer16 said...
trkane, I am on Rifampin. I have Rifabutin pulsing on this site. Wonder if it makes a difference?

When I was put on this many years ago I was told it is a "cleaner version of rifampin" and havent questioned it since.

It also is more expensive. My son used rifampin with his LLMD and he got better

I should ask about it in my next appt because it was definite sticker shock when I filled it for the first time in many years.